Title Pravilna interpretacija rezultata krvne grupe i direktnog antiglobulinskog testa kod neonatološke djece
Title (english) CORRECT INTERPRETATION OF BLOOD TYPE AND DIRECT ANTIGLOBULIN TEST IN NEWBORN
Author Maja Tarabene
Mentor Mirela Zec (mentor)
Committee member Ivana Franić (predsjednik povjerenstva)
Committee member Esma Čečuk-Jeličić (član povjerenstva)
Committee member Mirela Zec (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2016-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Uvod
Na samom početku uvoda prikazane su važnije godine u razvoju transfuzijske medicine kao što je otkriće krvnih grupa, Rhesus faktora, Coombsovog testa itd. U nastavku rada slijedi definiranje eritrocitnih antigena, njihove građe i funkcije za ljudski organizam. Eritrocitna membrana novorođenčeta do šestog mjeseca života nije u potpunosti razvijena, posljedično tome tek nakon šest mjeseci možemo dokazati djetetova antieritrocitna protutijela u serumu.
Krvne grupe se nasljeđuju prema Mendelovom zakonu, a sintezu određuje jedan gen ili skupina usko povezanih homolognih gena. A i B aleli su kodominantni dok je O alel recesivan. Uz određivanje ABO krvne grupe radi se i određivanje Rh faktora te Coombsovog testa. Postoje dvije vrste Coombsovog testa, direktni i indirektni o kojima se detaljnije govori u poglavlju 3.2. Određivanje Rh faktora je posebno važno u trudnoći. Ako je majka Rh negativna, a dijete naslijedi Rh pozitivan faktor od oca postoji mogućnost razvoja hemolitičke bolesti fetusa i novorođenčeta te može doći do kobnih posljedica.
Cilj
Cilj ovog rada je ukazati na važnost pravilnog izvođenja i interpretacije imunohematološkog testiranja neonatološke djece s ciljem sprječavanja ABO i Rh(D) imunizacija.
Izvori podataka i metode
U svakom laboratoriju postoje pravila i protokoli kojih se treba držati prilikom izvođenja imunohematološkog testiranja. Kao uzorak se koristi puna venska krv uzeta u epruvetu sa antikoagulansom EDTA. Postoje točno propisani reagensi koji se trebaju koristiti uključujući mikrokartice, 0.9% fiziološku otopinu NaCl-a, reagensi za hemotest u epruveti i na pločici, reagens za otkrivanje slabog Rh(D) antigena, otopina niske ionske jakosti Bio-LISS, suspenzija eritrocita A1, B i O za eritrotest u epruveti, otopina Diluent 2 i testni eritrociti.
Uz odgovarajuće reagense trebaju se koristiti i odgovarajući instrumenti koji su prethodno validirani te odgovarajući pribor u koji spadaju epruvete, mikropipete, plastični nastavci za mikropipete te stalci.
Rasprava
U raspravi je prikazan slučaj trudnice koja je O- krvne grupe, a nosi Rh(D) + dijete kojem je nakon poroda utvrđena A+ krvna grupa.
Zaključak
Pravilno izvođenje i interpretacija imunohematološkog testiranja majke i novorođenčeta je od iznimne važnosti jer se sprječavaju ABO i Rh(D) imunizacije. Testiranja su obvezna za svaku trudnicu, a ovisno o Rh(D) krvnoj grupi slijede daljnje kontrole po kalendaru. Svaka trudnica se poziva na odgovornost kako bi se osigurala što kvalitetnija zdravstvena skrb za nju i dijete.
Abstract (english) Introduction
All years that are important for the development of the transfusion medicine such as: the development of bood types, Rhesus factor, Coombs test and so on have been given at the begining of the introduction . The following text contains definitions of the erythrocyte antigens, their structures and functions in the human body. The erythroctye membrane of a newborn isn't fully developed until the sixth month of life, so based on that the anti-erythrocyte antibodies can firstly be detected in the serum after six months of life. Inheritance of a certain blood type follows the Mendelian law of inheritance and it consists of synthesis of a certain gene or a group of homologous genes. Alleles A and B are co-dominant and the allel 0 is recessive. Rh factor analysis as well as Coombs tests are preformed with the blood typing simultaneously. There are two types of a Coombs test, the direct and the indirect one which will be disscussed later in the Chapter 3.2. Knowing your Rh factor is very important during pregnancy. If the mother is Rh negative and the child has inherited Rh postive factor from the father the fetus has a chance of developing a fatal hemolythic disease of the newborn.
Objective
The objective of this assay is to highlight the importance of
Sources of information and methods
There are certain rules and protocols that have to be followed in each labaratory when a immunohematology testing is being preformed. Venous blood mixed with anticoagulant EDTA in a test tube is used as a sample. There is a prescribed list of reagents that should be used including: ortho biovue cassettes, 0.9 % saline solution of sodium chloride, reagents for hemotests for test tubes and plates, reagents for detection of weak Rh (D) antigene, low ione strength Bio-LISS solution, Diluent 2 solution and test erythrocytes.
Recomended instruments, that have been previously validated, should be used in alignment with the correct reagents and with the correct labaratory equipment which consists of: test tubes, micropipettes ,micropipettes tips and holders.
Discussion
In the discussion a case of a pregnant woman with O- blood type carring a Rh(D) + child who was diagnosed A+ blood type after birth is shown.
Conclusion
Correct handling and interpretation of immunohaematological testing of the mother and her newborn is vital in preventing ABO/Rh(D) immunisation. Every pregnant woman must be tested and further controls will depend on her Rh(D) blood type.
A sense of responsability must be shown by every pregnant woman during her pregnancy in order to insure that she and her child get the best medical care possible.
Keywords
krvne grupe
imunohematološko testiranje
novorođenče
Keywords (english)
blood type
immunohematology testing
newborn
Language croatian
URN:NBN urn:nbn:hr:176:617706
Study programme Title: Medical Laboratory Diagnostics (university/undergraduate) Study programme type: university Study level: undergraduate Academic / professional title: sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) medicinska laboratorijska dijagnostika (sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) medicinska laboratorijska dijagnostika)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-06-02 06:54:09